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File:IPLab6ChronicRejection12.jpg|Photomicrograph from another region of previous image. Note the cellular infiltrate around a small blood vessel (right) and neutrophils within renal tubules (arrow).
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== Study Questions ==
* <spoiler text="What is the pathogenetic mechanism of chronic transplant rejection?">Basically, chronic transplant rejection is the accumulated damage to the kidney that results from multiple episodes of acute transplant rejection. Despite immunosuppressive therapy, there is still some ongoing rejection and there are often flare-ups of acute rejection. Over time this cumulative damage results in loss of renal tissue and replacement by fibrous connective tissue.</spoiler>
* <spoiler text="Why does this case of chronic transplant rejection have cellular infiltrate and even some neutrophils (indicating acute inflammation)?">There is often ongoing rejection even in cases of long term transplant. This case and the images from the case of chronic rejection that was removed during an attack of acute rejection demonstrate the continuing ongoing nature of the rejection process.</spoiler>
* <spoiler text="What role do humoral antibodies play in chronic transplant rejection?">There is some controversy over this point. Some people think that since antibodies can be demonstrated in the vascular lesions (the intimal proliferation), these must be antibody-mediated. This is not necessarily true but the classic dogma is that chronic vascular rejection is both antibody-mediated and cell-mediated.</spoiler>
{{IPLab 6}}
[[Category: IPLab:Lab 6]]
